title: Effects of antidepressant treatment on corticotropin-induced cortisol responses in patients with melancholic depression.
abstract: To date, there appears to be no consensus of opinion as to whether the adrenal glands are hyperresponsive during depression and, if so, whether this a state-dependent phenomenon. We aimed to determine the effects of antidepressant treatment on ACTH-induced cortisol responses in patients with melancholic depression. Seven female patients with DSM-III-R major depressive disorder, non-psychotic, melancholic subtype, were evaluated using the following rating scales: the Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale and the Newcastle Endogenicity Scale. All subjects were then given an intravenous bolus dose (250 micrograms) of tetracosactrin, a potent stimulus of adrenocortical hormone secretion. Plasma levels of cortisol were measured at times 0, + 30, + 60, + 90, + 120 and + 180 min. Patients were then randomised to receive either 50 mg of sertraline or 20 mg of paroxetine (both of which are selective serotonin re-uptake inhibitors) and were re-tested while medication-free. Treatment resulted in a significant decrease in delta (the difference between the baseline values and the maximum increase post-ACTH administration) cortisol values of 1633.3 +/- 378.5 nmol/l vs. 595.1 +/- 207.7 nmol/l. Successful pharmacological treatment of major depressive disorder appears to be associated with a reduction in ACTH-induced cortisol release in drug-free patients.
authors.affiliation: Academic Department of Psychological Medicine, Royal London Hospital, UK. j.h.thakore@mds.qmw.ac.uk
authors.forename: J H
authors.initials: JH
authors.lastname: Thakore
authors.forename: C
authors.initials: C
authors.lastname: Barnes
authors.forename: J
authors.initials: J
authors.lastname: Joyce
authors.forename: S
authors.initials: S
authors.lastname: Medbak
authors.forename: T G
authors.initials: TG
authors.lastname: Dinan
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D003366:Cosyntropin; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000503:physiopathology; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015415:Biomarkers; D003366:Cosyntropin; D006854:Hydrocortisone; D017367:Selective Serotonin Reuptake Inhibitors